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New Hampshire rates for HCPCS 97163

Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.46 / $139.25 / $335.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.61 / $63.47 / $90.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.63 / $98.01 / $126.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.00 / $125.00 / $125.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.95 / $95.86 / $190.63
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $168.30 / $346.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.04 / $89.46 / $129.13
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.72 / $78.56 / $118.65